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development. The procedure includes the surgical removal of both breasts before any pathologic diagnosis has been made. Women that were previously diagnosed with a breast cancer in one breast (ipsilateral breast cancer) might elect to undergo risk-reducing mastectomy of the other unaffected (contralateral) breast, that is to say contralateral risk-reducing mastectomy (CRRM), to minimize the risk of a second breast cancer development. CRRM has been shown to reduce the incidence of contralateral breast cancer, but there is not sufficient evidence that it improves survival. Women who had a bilateral mastectomy in 2013 were about 10 years younger than those who had a unilateral mastectomy.
231:
A factor that facilitates the decision to undergo a preventive mastectomy is that results of breast reconstructive surgery have improved. A 2004 Canadian study found that 70% of women were satisfied or extremely satisfied with the reconstruction after bilateral prophylactic mastectomy. In the United
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The procedure is a surgical option for individuals who are at high risk for the development of breast cancer. High risk women without a prior history of personal breast cancer might consider bilateral risk-reducing mastectomy (BRRM) as an option for minimising the risk of primary breast carcinoma
144:
Male carriers of BRCA1 and BRCA2 mutations have a higher risk of breast cancer than other males, approximately 1.2% and 6.8%, but their risk is much lower than in female mutation carriers (about 60%) and lower than in the general female population (12%). Thus, preventive mastectomy has not been
140:
Undergoing a preventive mastectomy does not guarantee that breast cancer will not develop later, however, it reduces the risk by 90% in high risk women. Also, a preventive mastectomy may not be able to remove all breast tissue as some of it may be in the arm pit, near the collar bone, or in the
159:
In most situations the operation involves both breasts and thus represents a bilateral procedure. When cancer has affected already one breast, the other breast, still healthy, may be removed in a unilateral preventive mastectomy. Typically either a simple, a subcutaneous or a nipple-sparing
197:
There are other options to reduce the risk of future breast cancer. Intensified breast cancer screening for high risk women may detect cancer at an early, treatable stage. Certain medications that block the effect of
218:
reduces estrogen levels and the risk of both ovarian and breast cancer, however, the reduction in breast cancer risk is about 50% in high risk women as compared to 90% when preventive mastectomy is done.
137:
Discussions and decision should be made with the help of specialists who can use relevant information and statistical models to predict the individual lifetime risk of development of breast cancer.
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to undergo preventive mastectomy has given the procedure wider media attention. The trend towards prophylactic mastectomy appears to be less pronounced in Europe and India.
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695:
Metcalfe, K. A.; Semple, J. L.; Narod, S. A. (2004). "Satisfaction with breast reconstruction in women with bilateral prophylactic mastectomy: A descriptive study".
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Presence of high-risk breast lesions like lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH).
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A preventive mastectomy carries certain risks including those of anesthesia, bleeding, infection, pain, disfiguration, anxiety and disappointment.
820:
535:
Scheufler, O.; Fritschen, U. V. (2008). "Prophylaktische
Mastektomie bei Frauen mit hohem Brustkrebsrisiko: Indikationen und Alternativen".
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Zagouri, F.; Chrysikos, D. T.; Sergentanis, T. N.; Giannakopoulou, G.; Zografos, C. G.; Papadimitriou, C. A.; Zografos, G. C. (2013).
647:"Surgical Delay of the Nipple–Areolar Complex: A Powerful Technique to Maximize Nipple Viability Following Nipple-Sparing Mastectomy"
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changes (in weight, diet, exercise, avoidance of smoking, limiting alcohol) may reduce the risk to some degree.
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Carbine, Nora E; Lostumbo, Liz; Wallace, Judi; Ko, Henry (2018-04-05). Cochrane Breast Cancer Group (ed.).
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are removed, while the other two approaches preserve the nipple area for cosmetic reasons. To increase the
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Family history of breast cancer. The genetic risk can be passed down through the mother’s or father’s side.
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409:"Trends in Bilateral and Unilateral Mastectomies in Hospital Inpatient and Ambulatory Settings, 2005–2013"
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States preventive mastectomy is gaining increased acceptance. The decision of famous actresses such as
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can be performed in the same surgical setting, added after the mastectomy. Saline or silicone
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mutation carriers; this is the main indication for bilateral prophylactic mastectomy.
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495:"Prophylactic mastectomy: Who needs it, when and why: Prophylactic Mastectomy"
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Steiner, C.A.; Weiss, A. J.; Barrett, M.L.; Fingar, K.R.; Davis, P.H. (2016).
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Eliassen AH, Hankinson SE, Rosner B, Holmes MD, Willett WC (October 2010).
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may be used in the reshaping process and may be placed in a later setting.
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765:"Physical activity and risk of breast cancer among postmenopausal women"
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360:"Risk-reducing mastectomy for the prevention of primary breast cancer"
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Burke, Erin E.; Portschy, Pamela R.; Tuttle, Todd M. (January 2015).
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of the nipple area for preservation during mastectomy, a so-called "
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After surgery, routine screening for breast cancer is recommended.
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576:"Breast Cancer Risk Among Male BRCA1 and BRCA2 Mutation Carriers"
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Jensen, J. A.; Lin, J. H.; Kapoor, N.; Giuliano, A. E. (2012).
262:"Prophylactic mastectomy: Surgery to reduce breast cancer risk"
872:"Angelina example may spread prophylactic mastectomy in India"
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172:" procedure can be done several weeks before the mastectomy.
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Surgical removal of the breasts to reduce breast cancer risk
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Cancer in one breast and a family history of breast cancer.
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Eisemann, Bradley S.; Spiegel, Aldona J. (January 2018).
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mastectomy is performed. With the former the areola and
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821:"Angelina Jolie And The Rise Of Preventive Mastectomy"
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Handchirurgie · Mikrochirurgie · Plastische
Chirurgie
321:"Risk-Reducing Mastectomy and Breast Reconstruction"
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624:"BRCA mutations: cancer risk and genetic testing"
96:pertains to women with these characteristics:
626:. National Cancer Institute. January 30, 2018
580:JNCI Journal of the National Cancer Institute
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68:or risk-reducing mastectomy (RRM) is an
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709:10.1097/01.PRS.0000131877.52740.0E
697:Plastic and Reconstructive Surgery
119:to the chest before the age of 30.
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43:general surgeon/plastic surgeon
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376:10.1002/14651858.CD002748.pub4
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870:Kannan, Ramya (15 May 2013).
174:Reconstructive breast surgery
499:Journal of Surgical Oncology
145:advocated for affected men.
18:Preventive double mastectomy
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651:Annals of Surgical Oncology
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819:Nancy Shute (2013-05-14).
463:10.1177/000313481307900233
325:Clinics in Plastic Surgery
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663:10.1245/s10434-012-2528-7
337:10.1016/j.cps.2017.08.013
300:National Cancer Institute
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129:or breasts with diffuse
296:"Preventive Mastectomy"
66:prophylactic mastectomy
549:10.1055/s-2008-1038774
416:HCUP Statistical Brief
62:preventive mastectomy
33:Preventive mastectomy
450:The American Surgeon
94:preventive operation
76:so that the risk of
738:"My Medical Choice"
592:10.1093/jnci/djm203
260:Mayo Clinic staff.
234:Christina Applegate
131:microcalcification
74:remove the breasts
70:elective operation
918:Surgical oncology
769:Arch. Intern. Med
657:(10): 3171–3176.
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266:Mayo Clinic
84:Indications
897:Categories
856:2013-05-14
749:2013-05-15
305:2013-05-14
271:2013-05-14
244:References
227:Acceptance
212:exemestane
155:Mastectomy
876:The Hindu
679:207173683
221:Lifestyle
208:raloxifen
204:tamoxifen
166:viability
149:Procedure
39:Specialty
850:Newsweek
799:20975025
717:15277800
671:22829005
610:18042939
557:18716986
519:24965368
480:23664548
472:23336662
424:27253008
394:29620792
345:29080654
200:estrogen
178:implants
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601:2267289
429:7 March
385:6494635
125:Having
881:15 May
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675:S2CID
476:S2CID
412:(PDF)
105:BRCA2
101:BRCA1
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795:PMID
713:PMID
667:PMID
632:2020
606:PMID
553:PMID
515:PMID
468:PMID
431:2016
420:PMID
390:PMID
368:2019
341:PMID
236:and
825:NPR
785:PMC
777:doi
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